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Organization

VISCAYA DENTAL, LLC

Active
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Organization

VISCAYA DENTAL, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. TODD L. SHARP (OWNER)
(239) 573-2326
Entity
Organization

Contact information

Practice address
1501 VISCAYA PKWY, CAPE CORAL, FL 33990-6226
(239) 573-2329
(239) 573-4867
Mailing address
1501 VISCAYA PKWY, CAPE CORAL, FL 33990-6226

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
—
—
1223E0200X
Endodontics
—
—
1223G0001X
General Practice Dentistry
Primary
—
—
1223P0300X
Periodontics
—
—
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
—
—
124Q00000X
Dental Hygienist
—
—
126800000X
Dental Assistant
—
—

Other

Enumeration date
03/08/2013
Last updated
03/08/2013
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